Think pieces

There is a lot of debate around commissioning and it helps to be aware of differing views. This section contains reports and papers by various organisations with an interest in how health and social care services are commissioned and delivered. Some material reflects the opinions of patients and service users.

Note: The opinions outlined in the accompanying text are not necessarily ours.

Commissioning policy and practice

Practice-based commissioning: Reinvigorate, replace or abandon? (King's Fund 2008)
This calls for a 'matrix' model for PBC that recognises the multi-layered nature of commissioning, builds on relationships emerging from PBC and tackles issues around accountability and risk that have been obstacles to the policy's progress.

Towards world class commissioning competency (University of Birmingham 2007)
This paper says defining and developing commissioning competency depends not just on knowledge and skills but values and motivation. Relevant skills already exist in the NHS but should be more effectively mobilised, or incorporated from other sectors.

How can PCTs shape, reflect and increase public value? (University of Birmingham 2007)
This paper explores options available to PCTs as they seek to embody 'NHS local', with a focus on broader social values. It outlines questions commissioners need to address to be able to define and increase 'public value'.

In sickness and in health: How the NHS can help tackle health inequalities (NHS Confederation 2007)
This paper outlines the government's approach to health inequalities and public opinion on the issue and suggests possible solutions, like identifying people who do not access the services they need and finding out why current services aren't used.

Public and patient involvement in the NHS (British Medical Association 2008)
This paper argues that local involvement networks (LINks) intended to give local communities more say in commissioning will have the opposite effect without national guidelines and funding for resources.

ISTCs and the NHS - sticking plaster, not real reform (CBI 2008)
The CBI views independent sector treatment centres (ISTCs) as a success but says more can be done to exploit their full potential, highlighting barriers such as poor initial needs analysis and demand projection, and local NHS resistance.

Under one roof: Will polyclinics deliver integrated care? (King's Fund 2008)
This paper reviews the opportunities and risks of adopting polyclinic models, the potential impact on quality, access and cost, and best and worst case implementation scenarios.

Commissioning for care groups

Bridging the gaps: Social exclusion of BME elders (Housing Associations' Charitable Trust 2007)
This briefing says lack of knowledge about certain minority populations and a tendency to overlook BME elders or make assumptions about them, means their needs remain hidden and service provision is inappropriate.

The future of care funding: Who pays for long-term care (Caring Choices 2008)
This paper reflects the views of older people, their carers and others directly involved in long-term care, who want a simpler funding system to make it easier to plan ahead and to have more control over services obtained with state support.

Lost: Low earners and the elderly care market (Resolution Foundation)
This research looks at older people's long-term care from the perspective of low earners, who may rely on unpaid carers and also take on this role for others, and warns that reliance on informal care to fill supply shortfalls is not sustainable.

Funding tomorrow today: Social care for older people and vulnerable adults (NHS Confederation 2008)
This offers reasons why the current social care system fails to deliver targeted services to everyone who could benefit, like lack of integration, missed opportunities for prevention and problems differentiating between health and social care.

Short changed: Spending on prison mental health care (Sainsbury Centre for Mental Health 2008)
This paper argues that spending on prison mental health care is not enough to accommodate a higher level of need, and does not achieve 'equivalence' in line with government policy.

Safe as houses: What drives investment in social care? (Commission for Social Care Inspection 2007)
This paper is based on consultation with private investors to explore what encourages them to put money into social care, what drives innovation and where funding could come from to reconfigure and personalise services.